Provider Demographics
NPI:1558405571
Name:SOUTHWEST SHOULDER ELBOW & HAND CENTER PC
Entity Type:Organization
Organization Name:SOUTHWEST SHOULDER ELBOW & HAND CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-290-4263
Mailing Address - Street 1:4727 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-290-4263
Mailing Address - Fax:520-290-0327
Practice Address - Street 1:4727 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-290-4263
Practice Address - Fax:520-290-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ22467Medicaid
AZ1271110001Medicare NSC